Pregnancy Outcomes of Adenomyosis after Treatment with High-intensity Focused Ultrasound: a Systematic Review and Meta Analysis

This systematic review and meta analysis was conducted to investigate the reproductive outcomes in the patients with adenomyosis after HIFU treatment, aimed to recommend HIFU treatment for those women with adenomyosis who have reproductive demand. Extensive search was performed through PubMed, EMBASE and Web of Science databases. All available studies that evaluated the reproductive outcomes after HIFU for adenomyosis. Systematic review was performed following PRISMA guidelines. A meta-analysis was performed on data from 15 studies involving 3730 patients with adenomyosis. Pooled results showed that the pregnancy rate (PR) in women who desired to conceive was 54.6%, the live-birth rate (LBR) based on pregnancy was 75.8%, and the possible prognostic factors were non-perfused volume (NPV%) and type of adenomyosis. This review suggests that HIFU was easier to operate, with less adverse events and noninferior to adenomyomectomy. Patients with higher non-perfused volume (NPV%) and focal or internal adenomyosis had more improvement in reproductive outcomes after HIFU treatment. However, the well-designed, prospective, randomized controlled trials (RCT) are needed to compare the reproductive outcomes in those adenomyosis patients after HIFU in the near future. Similar content being viewed by others Data Availability Data is available from the authors upon reasonable request. Code Availability Not applicable.

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Uterine rupture after high-intensity focused ultrasound ablation of adenomyosis: a case report and literature review. Int J Hyperthermia. 2023;40(1):2212885. https://doi.org/10.1080/02656736.2023.2212885 Lai THT, Seto MTY, Cheung VYT. Intrapartum uterine rupture following ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroid and adenomyosis. Ultrasound Obstet Gynecol. 2022;60(6):816–7. Funding This work was supported by a program from the Jiangsu Center for Reproductive Medicine Innovation (CXZX202207). Author information Authors and Affiliations Contributions All authors contributed to the study conception and design. Data collection and analysis were performed by Jiale Liang and Yugui Cui. The Statistical Analysis were performed by Li Gao and Guodong Sun. The first draft of the manuscript was written by Jiale Liang and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Corresponding author Ethics declarations Conflict of interest The authors have no relevant financial or non-financial interests to disclose. Additional information Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Supplementary Information Below is the link to the electronic supplementary material. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Liang, J., Gao, L., Sun, G. et al. Pregnancy Outcomes of Adenomyosis after Treatment with High-intensity Focused Ultrasound: a Systematic Review and Meta Analysis. Reprod. Sci. 33, 75–83 (2026). https://doi.org/10.1007/s43032-025-02031-1 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s43032-025-02031-1